Thyroidectomy, although rare, may be performed for patients with thyroid cancer, hyperthyroidism, and drug reactions to antithyroid agents; pregnant women who cannot be managed with drugs; patients who do not want radiation therapy; and patients with large goiters who do not respond to anti-thyroid drugs.
The two types of thyroidectomy include:
- Total thyroidectomy: The gland is removed completely. Usually done in the case of malignancy. Thyroid replacement therapy is necessary for life.
- Subtotal thyroidectomy: Up to five-sixths of the gland is removed when antithyroid drugs do not correct hyperthyroidism or RAI therapy is contraindicated.
Thyroidectomy requires meticulous postoperative nursing care to prevent complications. Nursing priorities will include managing hyperthyroid state preoperatively, relieving pain, providing information about the surgical procedure, prognosis, and treatment needs, and preventing complications.
- Acute Pain
- Risk for Impaired Airway Clearance
- Impaired Verbal Communication
- Risk for Injury
- Deficient Knowledge
Impaired Verbal Communication
- Impaired Verbal Communication
May be related to
- Vocal cord injury/laryngeal nerve damage
- Tissue edema; pain/discomfort
Possibly evidenced by
- Impaired articulation, does not/cannot speak; use of nonverbal cues such as gestures
- Client will establish a method of communication in which needs can be understood.
|Assess speech periodically. Encourage voice rest.||Hoarseness and sore throat may occur secondary to tissue edema or surgical damage to the recurrent laryngeal nerve and may last several days. Permanent nerve damage can occur (rare) that causes paralysis of vocal cords and/or compression of the trachea.|
|Keep communication simple. Ask yes or no questions.||Reduces demand for response and promotes voice rest.|
|Provide alternative methods of communication as appropriate: slate board, picture board. Place IV line to minimize interference with written communication.||Facilitates the expression of needs.|
|Anticipate needs as possible. Visit patient frequently.||Reduces anxiety and patient’s need to communicate.|
|Post notice of the patient’s voice limitations at central station and answer call bell promptly.||Prevents patient from straining voice to make needs known or summon assistance.|
|Maintain a quiet environment.||Enhances ability to hear whispered communication and reduces the necessity for the patient to raise or strain voice to be heard.|
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Endocrine and Metabolic Care Plans
Nursing care plans related to the endocrine system and metabolism:
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- Addison's Disease | 3 Care Plans
- Cushing’s Disease | 6 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Diabetes Mellitus Type 2 | 13+ Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 4 Care Plans
- Eating Disorders: Anorexia & Bulimia Nervosa | 7 Care Plans
- Fluid and Electrolyte Imbalances | 10 Care Plans
- - Fluid Balance: Hypervolemia & Hypovolemia
- - Potassium (K) Imbalances: Hyperkalemia and Hypokalemia
- - Sodium (Na) Imbalances: Hypernatremia and Hyponatremia
- - Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia
- - Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperthyroidism | 7 Care Plans
- Hypothyroidism | 3 Care Plans
- Obesity | 4 Care Plans
- Thyroidectomy | 5 Care Plans